Michael John Padrta

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

12512 SE Stark St
Portland, OR 97233-1070

Phone

(503) 906-9995

NPI assigned

Nov 7, 2023

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1699315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1083488480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12540 SW MAIN ST",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972236198",
            "telephone_number": "503-906-9995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12512 SE STARK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331070",
            "telephone_number": "503-906-9995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADRTA",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-07",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wade Austin Padgett, MA, QMHP
• Thalia Yesmin Padilla Kelley, MD
• Emily Teresa Padilla, L14636
• Gabriela Marie Padilla, QMHA
• Elisa Padron, MD
• Padua Adult Foster Home Care, LLC
• Cherrie Mae Padua
• Mervin Padua, LPN
• Molly Kathleen Padulo, MA
• Andrew Jooyoung Paek, DC

• Peer Specialist in Portland, OR
• Providers in Portland, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.